AB1399 PEOPLE SUFFERING FROM RHEUMATIC AND MUSCULOSKELETAL DISEASES DESCRIBE THEIR OWN EXPERIENCES OF INTEGRATED CARE: FINDINGS FROM A CROSS‑SECTIONAL STUDY AMONG ITALIAN PATIENTS
Authors: N. Spezia, S. Barello, C. Torri, A. Celano, G. Graffigna
Journal: Annals of the Rheumatic Diseases (2022)

Background Integrated care is an approach to health care based on multidisciplinary working and the continuity and coordination of different levels of care (1). In an integrated care setting, health services are designed to go beyond fragmentation and isolation and delivered in response to chronic patient health needs. Integrated care has been proved to enhance patients’ quality of life (2), as well as reduce hospital admission rates and length of stay (3). Furthermore, integrated care favors patients’ access to care and improves their satisfaction (4). To evaluate the application and benefits of integrated care, patient experiences should be measured (5). However, while the patient experiences of integrated care have been documented for various chronic diseases, little is known in the context of rheumatic and musculoskeletal diseases (RMDs). Objectives This study aims at providing an overview of the patient experience of integrated care of RMDs patients in Italy and defining the experience profiles and priorities of different patient subgroups. Methods A cross-sectional online self-administered survey formulated following a scoping review of the literature was administered to a purposive sample of Italian RMDs patients (n=433). Respondents were asked to evaluate their patient experience and the importance attributed to different aspects of integrated care. Explorative factor analysis (EFA) was performed to determine the dimensions of integrated care investigated by the survey. The differences in the responses provided by different subgroups of the sample were assessed using the non-parametric versions of ANOVA and ANCOVA statistical tests with Scheffe’s adjustment for multiple comparisons. Results Two factors (“person-centered care” and “health service delivery”) were extracted in the EFA. Respondents attributed high importance to both of them. However, an overall positive experience was reported only for the dimension of person-centered care. The delivery of integrated care services was evaluated poorly, especially for digital ones. Women described both dimensions of integrated care as more important compared to men (H(1)=45.292, p&lt;.001 and H(1)=6.998, p=.008). However, their experience of integrated care services was significantly worse (H(1)=20.201, p&lt;.001). Older participants reported poorer health service delivery compared to younger ones (H(3)=73.203, p=.009), especially for digital and outpatient services. Person-centered care was especially important for patients with comorbidities (F(1,431)=4.944, p=.027). However, this subgroup reported markedly worse experiences of integrated care services (F=(1,431)=4.187, p=.041). Conclusion Italian RMDs patients identified integrated care as something important to them. They reported receiving positive person-centered care but the delivery of integrated care services was evaluated poorly. Different patient subgroups described different experience profiles and priorities. This diversification can inform the design of tailored interventions to address the specific concerns and needs of each patient subgroup. References [1]Goodwin N. Understanding Integrated Care. Int J Integr Care 2016; 16: 1–4 [2]Flanagan S, Damery S, Combes G. The effectiveness of integrated care interventions in improving patient quality of life (QoL) for patients with chronic conditions. An overview of the systematic review evidence. Health Qual Life Outcomes 2017; 15: 1–11 [3]Liljas AEM, Brattström F, Burström B, et al. Impact of Integrated Care on Patient-Related Outcomes Among Older People – A Systematic Review. Int J Integr Care 2019; 19: 1–16 [4]Baxter S, Johnson M, Chambers D, et al. The effects of integrated care: A systematic review of UK and international evidence. BMC Health Serv Res 2018; 18: 1–13 [5]Rijken M, Lette M, Baan CA, et al. Assigning a Prominent Role to “ The Patient Experience ” in Assessing the Quality of Integrated Care for Populations with Multiple Chronic Conditions. Int J Integr Care 2019; 19: 1–5 Acknowledgements The authors would like to thank all the patients who made this research possible. Disclosure of Interests None declared